The You Factor in Psychotherapy

Did you know that you are the most important factor in your therapy? It may seem surprising given the amount of time we spend searching for the right provider and the right therapy approach. However, research shows that around 55% of therapy outcome is related to extra-therapeutic factors such as client readiness for change, willingness, commitment, hope and expectations of effectiveness, and resources such as social support.

The client-therapist relationship is the second largest factor associated with treatment outcome (about 30%) and this includes things like the therapeutic alliance and therapist characteristics such as verbal skills, empathy, and warmth. Interestingly, the therapy approach only accounts for about 15% of the variance in outcomes.

This can be viewed as good news on a couple of levels. It means that a wide variety of therapy approaches can be beneficial to most people and we don’t have to be overly concerned if a particular approach is not readily available. If you live in a moderately sized town, the pool of therapists available to you where you live and work is probably sufficient for a good outcome. It also means that there may be a number of factors that are within your control to positively impact treatment outcome. You are the most important variable in your treatment and you are the only thing you really have any control over.

So what can you do to help your therapy be maximally effective? Approach therapy with at least a modicum of hope and trust that the process could be helpful to you. Adopt a beginner’s mind that is reasonably free from snap judgments and assumptions. Allow yourself to be open to new people and approaches. Get out of automatic pilot by becoming more aware – paying attention, on purpose, to your own inner experiences (thoughts, feelings and physical sensations) in the moment. Be a curious observer. Think about what you want to address in your sessions and be an active participant in the process. Communicate openly with your therapist. Build motivation for and commitment to change. Dedicate time between sessions to do homework and follow through with your therapist’s suggestions. Experiment. Practice good self care and actively seek out additional resources that you can access as needed.

Often the most helpful assistance will not be available to you until you are open to it – in other words, until you are ready. Have you heard the saying, “When the student is ready, the teacher will appear”? Ram Dass said that you will probably pass by your greatest potential helpers or teachers, seeing them as “kooks, nuts, cranks, or people who do those things“, until you begin to ask yourself the necessary questions. Only then will you begin to see that “everything in your universe becomes your teacher”.